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Thomas J. Bollyky is senior fellow for global health, economics, and development at the Council on Foreign Relations (CFR). He is also an adjunct professor of law at Georgetown University. In 2014, Bollyky directed the first CFR-sponsored Independent Task Force devoted to global health and development, entitled The Emerging Global Health Crisis: Noncommunicable Diseases in Low- and Middle-Income Countries.

Prior to coming to CFR, Bollyky was a fellow at the Center for Global Development and a director at the Office of the U.S. Trade Representative (USTR), where he led the negotiations on medical technology regulation in the U.S.-Republic of Korea Free Trade Agreement and represented USTR in the negotiations with China on the safety of food and drug imports. He was also a Fulbright scholar to South Africa, where he worked as a staff attorney at the AIDS Law Project on treatment access issues related to HIV/AIDS, and an attorney at Debevoise & Plimpton LLP, where he represented Mexico before the International Court of Justice in Avena and other Mexican Nationals (Mexico v. United States of America) and Jose Ernesto Medellín before the U.S. Supreme Court in Medellin v. Dretke. Bollyky is a former law clerk to Chief Judge Edward R. Korman, an international affairs fellow at CFR, and a health policy analyst through the outstanding scholar program at the U.S. Department of Health and Human Services.

Bollyky has testified multiple times before the U.S. Senate and his work has appeared in the New York Times, Science, Foreign Affairs, the Journal of the American Medical Association, and the Lancet. Bollyky has served in a variety of capacities at the National Academy of Medicine, including as co-chair of its workshop on international regulatory harmonization amid globalization and as a member of committees on strengthening food and drug regulation in developing countries and on the role of science, technology, and innovation in the future of the U.S. Agency for International Development. He has also served as a consultant to the Bill & Melinda Gates Foundation and as a temporary legal advisor to the World Health Organization. In 2013, the World Economic Forum named Bollyky as one of its global leaders under forty.

Bollyky received his BA in biology and history at Columbia University and his JD at Stanford Law School, where he was the president of the Stanford Law & Policy Review. He is a member of the New York and U.S. Supreme Court bars.

A New Agenda for Changing Global Health Needs

Global health is in transition. As the Ebola outbreak in West Africa demonstrated, the exotic parasites, bacterial blights, and infectious diseases that have long occupied international health initiatives remain important, but these health threats are declining in most countries and in every region of the world. That is good news, but this epidemiological transition is not yielding the demographic and economic benefits that accompanied that transition in wealthier countries. Cancers, heart disease, and noncommunicable diseases are increasing in prevalence faster, arising in younger and poorer populations, and having worse outcomes than seen in wealthy nations. Changes in global trade, urbanization, and the still nascent regulatory and health-care systems in emerging economies have also put a new set of health challenges—from food insecurity, antibiotic resistance, and environmental pollution to road safety, tobacco use, and substandard medicines—on the agenda for policymakers, businesses, and local communities. My research examines the strategic, economic, and humanitarian objectives that underlie U.S. and international priorities and investments in global health and how to ensure their continued effectiveness in the face of the world's changing health needs. As part of this work, I directed CFR's Independent Taskforce on Noncommunicable Diseases and host the Global Health, Economics, and Development Roundtable Series.

Better Regulation for Freer Trade

Changes in the way the world trades have increased the importance of regulation in international commerce. Fewer goods and services originate "from" any one place or any one supplier, but rather consist of components and tasks from multiple suppliers scattered across several countries. Consistent, adequate, and predictable regulation is essential to the success of these global supply chains, but remains elusive. Without international coordination, national regulations and private standards have proliferated. The resulting chaos has done little to promote exports or effective regulatory oversight. Uncoordinated regulations challenge multinational corporations and small- and medium-sized businesses alike and keep developing country goods from entering new markets. Given the scale and complexity of global supply chains, the adequacy of health, safety, and environmental regulation in one country increasingly depends on the adequacy and consistency of those regulations in other countries. In this environment, trade negotiators and regulators need one another, but have struggled to develop the arrangements that can foster the necessary cooperation. My work examines the changing role of regulation in international commerce, its implications for international trade initiatives and institutions, and strategies and approaches that can promote better regulatory cooperation for freer trade.

To continue the extraordinary progress of the past fifteen years, the next U.S. administration should further integrate global health, development, and pandemic preparedness into the U.S. national security architecture, write CFR's Thomas J. Bollyky and Eric Goosby, former U.S. AIDS Coordinator and UN Special Envoy on Tuberculosis.

Global value chains have changed the way that the world trades. The World Trade Organization (WTO) should embrace the confluence of shared social preferences and trade, where it may exist such as digital trade, food and drug safety, and climate smart-agriculture, as a motivation for advancing international regulatory cooperation. To do that, changes to the corporate governance of the WTO are needed to facilitate the use of plurilateral agreements and to multilateralize progress already occurring bilaterally and regionally.

The special exemptions for tobacco products in the TPP trade deal say less about cross-border investment rules generally, and more about the unique nature of tobacco under U.S. and international law, writes CFR's Thomas Bollyky.

The amount of international aid given to address noncommunicable diseases is minimal. Most of it is directed to wealthier countries and focuses on the prevention of unhealthy lifestyles. Explanations for the current direction of noncommunicable disease aid include that these are diseases of affluence that benefit from substantial research and development into their treatment in high-income countries and are better addressed through domestic tax and policy measures to reduce risk-factor prevalence than through aid programs. This study assessed these justifications. First, we examined the relationships among premature adult mortality, defined as the probability that a person who has lived to the age of fifteen will die before the age of sixty from noncommunicable diseases; the major risk factors for these diseases; and country wealth. Second, we compared noncommunicable and communicable diseases prevalent in poor and wealthy countries alike, and their respective links to economic development. Last, we examined the respective roles that wealth and risk prevention have played in countries that achieved substantial reductions in premature mortality from noncommunicable diseases. Our results support greater investment in cost-effective noncommunicable disease preventive care and treatment in poorer countries and a higher priority for reducing key risk factors, particularly tobacco use.

The way the world trades has changed since the World Trade Organization (WTO) was established. Fewer goods and services originate from any one supplier or country. Components and intermediate services are increasingly sourced and assembled from specialist suppliers around the world. Regulation also plays a more significant role in this era of international trade. The adequacy of regulatory oversight has become more important as complex, unbundled global supply chains have become harder for businesses and customers to monitor.

Once thought to be challenges for affluent countries alone, cancer, cardiovascular diseases, diabetes, and other noncommunicable diseases are now the leading cause of death and disability in developing countries. The economic and human costs are high and rising in low- and middle-income countries, threatening their continued development prosperity. Lung, liver, cervical and breast cancers constitute a large proportion of this growing burden and can be addressed with life-saving and low-cost interventions.

In recent years, frugal and reverse innovation have gained attention as potential strategies for increasing the quality and accessibility of health care while slowing the growth in its costs. Thomas J. Bollyky argues that the demand for these types of innovation is increasing and outlines three practical questions for policymakers seeking real investments and results.

In his testimony before the Senate Foreign Relations Subcommittee on Africa and Global Health Policy, Thomas J. Bollyky argues that continued U.S. and private sector leadership on the unfinished health agenda in Africa is as important now as it has been in the past and for the same reasons: a peaceful, inclusive economy presupposes healthier, more productive lives.

The WHO’s tobacco treaty in 2005 was hailed as a crucial tool for controlling one of the world’s most lethal substances and as a model for confronting other global health problems. Ten years later it is a qualified success, write CFR’s Thomas J. Bollyky and David P. Fidler.

Dramatic changes in urbanization, global trade, and consumer markets – which occurred over decades in wealthy countries – are happening at a faster rate, and at a much larger scale, in still-poor countries. These trends have brought substantial health benefits, but have given rise to significant challenges as well.

Once thought to challenge only affluent countries, cardiovascular disease, cancer, diabetes, and other non-communicable diseases (NCDs) are now the leading cause of death and disability in low-income and middle-income countries. International efforts should focus on specific NCDs and risk factors that are prevalent in poor working-age (younger than 60 years) people in low-income and middle-income countries, and for which there are low-cost interventions that can be integrated with existing global health platforms.

The gravest health threats facing low- and middle-income countries are not the plagues, parasites, and blights that dominate the news cycle and international relief efforts. They are the everyday diseases -- heart disease, cancer, diabetes, and chronic respiratory illnesses -- we understand and could address, but fail to take action against.

The popularity of e-cigarettes presents an enormous opportunity for public health, which the United States is at risk of squandering by regulating these products as tobacco, writes CFR's Thomas Bollyky.

Press/Panels

On America Abroad Radio, Thomas Bollyky discusses the need to focus more U.S. global health resources on diseases that don't make headlines, like cardiovascular disease, cancers, and diabetes, in the context of a discussion on global health preparedness in the wake of the Zika outbreak.

Newsweek covers Thomas Bollyky's claim that special exemptions for tobacco products in the TPP trade deal say less about cross-border investment rules generally, and more about the unique nature of tobacco under U.S. and international law.

In an interview with the New York Times, Thomas Bollyky comments on the reported exclusion of tobacco control measures from being subject to investor-state disputes under the Trans-Pacific Partnership trade agreement.

In an interview with the ASCO Post, Thomas Bollyky discusses the findings and recommendations of the report of the CFR-sponsored Independent Task Force on Noncommunicable Diseases–CFR’s first on a global health matter.

In an interview with Marketplace World, Thomas Bollyky discusses the high rates of soda consumption in Mexico and the potential for a soda tax to reduce consumption and increase access to safe drinking water.

In an interview with the New York Times, Thomas Bollyky discusses the newly-released report from the CFR-sponsored Independent Task Force on Noncommunicable Diseases–CFR’s first on a global health matter.

In an interview with El Colegio de México, Thomas Bollyky discusses the Transatlantic Trade and Investment Partnership, its implications for transatlantic trade, and the future of pending U.S. trade deals.

In an interview with the Canadian Broadcasting Company, Thomas Bollyky discusses low- and middle-income countries' anti-tobacco legislation and the resulting legal challenges stemming from trade and investment treaties.

In an interview with the New York Times, Thomas Bollyky comments on the difficulties countries experience in implementing tobacco control measures when faced with legal action by international tobacco companies to stop such measures.

The editorial board of the Washington Post endorses Thomas Bollyky's proposal for how tobacco should be addressed in the Trans-Pacific Partnership and links his policy innovation memorandum, "The Tobacco Problem in U.S. Trade."

The Lancet republished an open letter by Gro Harlem Brundtland, former Director-General of the World Health Organization and former Prime Minister of Norway, Harald zur Hausen, winner of the 2008 Nobel Prize in Medicine, and fifty other eminent physicians that calls for medical and humanitarian access to Syria, citing research by Thomas Bollyky.

Quartz discusses Thomas Bollyky's expert brief, "The Tobacco Problem in U.S. Trade," and how free trade facilitates the sale and use of tobacco products to women and children in low- and middle-income countries.

In an interview with Inside U.S. Trade, Thomas Bollyky discusses international regulatory cooperation and its potential benefits for the United States and European Union in the pending Transatlantic Trade and Investment Partnership negotiations.

U.S. Representative Charles B. Rangel, ranking member of the Subcommittee on Trade on the House Ways and Means Committee, cites Thomas Bollyky's CFR policy innovation memorandum, Better Regulation for Freer Trade, and its regulatory applications in upcoming trade negoations with the United States and European Union in The Hill.

Thomas Bollyky discusses findings from the Global Burden of Disease Study2010 and the rapid rise of noncommunicable diseases in low- and middle-income countries on the radio program "For Your Ears Only."

Forbes covers Thomas Bollyky's roundtable event on the one-year anniversary of the United Nations High-Level Meeting on the Prevention and Control of Noncommunicable Diseases, "The Rise of NCDs in Low- and Middle-Income Countries," featuring U.S. Centers for Disease Control and Prevention Director Thomas R. Frieden.

As we've heard this week, Geneva is hosting the 65th session of the World Health Assembly meeting. Participants have tackled a range of public health issues such as universal health coverage, mental disorders and polio eradication. They've also addressed the issue of non-communicable diseases (NCDs) such as diabetes, cancer and stroke which are now the leading causes of death and disability in nearly every region of the world. Indeed some health experts say the international community needs to do much more in tackling NCDs particularly in the developing world. One of those calling for action is Thomas Bollyky, Senior Fellow for Global Health, Economics, and Development at the Council on Foreign Relations in the United States. He told WRS reporter Vincent Landon about the scale of the problem.

For the first time, the top spot at the World Bank may not go to an American. Two candidates vying for the presidency represent developing nations.

Business News Network interviews Thomas Bollyky, Senior Fellow for Global Health, Economics, and Development, along with Lant Pritchett, Professor of International Development at the Harvard Kennedy School of Government, and Wilson Prichard, Professor of Political Science at the University of Toronto.

Professor Jim Riviere, Thomas Bollyky, and other authors of the Institute of Medicine's Ensuring Safe Foods and Medical Products Through Stronger Regulatory Systems Abroad report outlined their findings at the National Press Club in Washington, DC.

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Featured Press

On America Abroad Radio, Thomas Bollyky discusses the need to focus more U.S. global health resources on diseases that don't make headlines, like cardiovascular disease, cancers, and diabetes, in the context of a discussion on global health preparedness in the wake of the Zika outbreak.

In an interview with El Colegio de México, Thomas Bollyky discusses the Transatlantic Trade and Investment Partnership, its implications for transatlantic trade, and the future of pending U.S. trade deals.